NPIMap

Organization Active NPI

WK Neurovascular Neurosurgery

  • Neurological Surgery Physician
  • Shreveport, LA
National Provider Identifier
1740057488
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
WK NEUROVASCULAR NEUROSURGERY
Practice address
2727 Hearne Ave Ste 320
Shreveport, LA 71103-3917
Phone
(318) 212-6797
Fax
(318) 212-6822
NPI assigned
Dec 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Jane Ward
Title
Sr. VP of Finance
Phone
(318) 716-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

2727 Hearne Ave Ste 320
Shreveport, LA 71103-3917

Mailing address

2727 Hearne Ave Ste 320
Shreveport, LA 71103-3917
Phone (318) 212-6797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403001650 LA Part B Supplier - Clinic/Group Practice 9537507041 Receives reassigned benefits from 7 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2727 Hearne Ave
Ste 320
Shreveport, LA 71103
Phone (318) 212-6797

2727 Hearne Ave
#320
Shreveport, LA 71103

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1740057488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 320",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033917",
            "telephone_number": "318-212-6797",
            "fax_number": "318-212-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 320",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033917",
            "telephone_number": "318-212-6797",
            "fax_number": "318-212-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK NEUROVASCULAR NEUROSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "SR. VP OF FINANCE",
        "authorized_official_telephone_number": "318-716-4939"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.